Provider Demographics
NPI:1881691756
Name:MEEKS, WROPHAS (MD)
Entity type:Individual
Prefix:DR
First Name:WROPHAS
Middle Name:
Last Name:MEEKS
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:500 LINCOLN DR
Mailing Address - Street 2:STE C
Mailing Address - City:HERRIN
Mailing Address - State:IL
Mailing Address - Zip Code:62948-6334
Mailing Address - Country:US
Mailing Address - Phone:618-998-9633
Mailing Address - Fax:618-998-9623
Practice Address - Street 1:500 LINCOLN DR
Practice Address - Street 2:STE C
Practice Address - City:HERRIN
Practice Address - State:IL
Practice Address - Zip Code:62948-6334
Practice Address - Country:US
Practice Address - Phone:618-998-9633
Practice Address - Fax:618-998-9623
Is Sole Proprietor?:Not Answered
Enumeration Date:2005-07-07
Last Update Date:2007-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL2085R0202X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2085R0202XAllopathic & Osteopathic PhysiciansRadiologyDiagnostic Radiology
Provider Identifiers
StateIdentifier IDID TypeIssuer
ILC38118Medicare UPIN
IL703280Medicare ID - Type UnspecifiedMEDICARE GROUP #
ILL85565Medicare ID - Type UnspecifiedMEDICARE INDIVIDUAL #